An Evaluation of Challenges and Opportunities for Western Heads East [2017]

Western Heads East (WHE) is “a collaboration between Western staff, students, faculty, and African partners using probiotic food to contribute to health and sustainable development”. The primary objective of this program is to establish a sustainable grassroots social enterprise using the health benefits of probiotic yoghurt in order to improve health of Tanzanian community while empowering local women to become business owners and entrepreneurs. This report investigates the challenges, opportunities, local conditions and previous works to recommend a potential intervention that could support the sustainability and the intended value of probiotic yoghurt kitchens. There are two main end users for the WHE programs: the yoghurt kitchen clients, and the “Yoghurt Mamas” themselves. The clients of the yoghurt kitchens come from all sections of society, including HIV+, malnourished, ill, and low-income. “Yoghurt Mamas” refer to women who operate the yoghurt kitchens in their communities and provide education on health, nutrition, HIV prevention and domestic abuse. Two of the challenges come from the end users themselves are the misconception by clients that the yoghurt is a medication, and a negative cultural attitude toward women, resulting in decreased creativity and independence. In addition, poverty, women and children’s social hierarchy, lack of education, government restrictions poor infrastructure and technology in the local community makes the health problem even more complex. To further diagnose the health problem, previous reports on yoghurt kitchens businesses by the African Probiotic Yoghurt Network, past WHE Intern Reports and the Oyugis. Kenya Project were examined before designing an intervention. Based on research and collaborative teamwork, a three-pronged approach was essential for mitigating the current challenges and enhancing the success of the WHE kitchens. They include creating a strategic marketing plan, improving communication among the WHE team 3 and the Yoghurt Mamas, and empowering women to help them discover and find value in their strengths. To deliver the intervention, some of the major actions include: Design simple, eye-catching, visually appealing posters and using community leaders as a channel of word-of-mouth promotion. Improve the packaging of the probiotic yoghurt sachets, including the benefits and the instructions that is easy for users to understand and follow. Enhance the communication between the WHE organization, interns and Mamas by using the Internal Communication Matrix. Facilitate a workshop focusing on business literacy skills for empowering the Mamas. Some metrics to evaluate the progress of the three-pronged intervention include: Tracking the channel of promotion that the clients experienced such as word-of-mouth or posters. Feedback on the relative success or failure of the yogurt kitchen in relation to the previous year (when ICM was not implemented) from the Mamas. Questionnaires and feedback from the Mamas after the business literacy worksho

The magnitude and severity of abortion-related morbidity in settings with limited access to abortion services:a systematic review and meta-regression

Introduction: Defining and accurately measuring abortion-related morbidity is important for understanding the spectrum of risk associated with unsafe abortion and for assessing the impact of changes in abortion-related policy and practices. This systematic review aims to estimate the magnitude and severity of complications associated with abortion in areas where access to abortion is limited, with a particular focus on potentially life-threatening complications. Methods: A previous systematic review covering the literature up to 2010 was updated with studies identified through a systematic search of Medline, Embase, Popline and two WHO regional databases until July 2016. Studies from settings where access to abortion is limited were included if they quantified the percentage of abortion-related hospital admissions that had any of the following complications: mortality, a near-miss event, haemorrhage, sepsis, injury and anaemia. We calculated summary measures of the percentage of abortion-related hospital admissions with each complication by conducting meta-analysis and explored whether these have changed over time. Results: Based on data collected between 1988 and 2014 from 70 studies from 28 countries, we estimate that at least 9% of abortion-related hospital admissions have a near-miss event and approximately 1.5% ends in a death. Haemorrhage was the most common complication reported; the pooled percentage of abortion-related hospital admissions with severe haemorrhage was 23%, with around 9% having near-miss haemorrhage reported. There was strong evidence for between-study heterogeneity across most outcomes. Conclusions: In spite of the challenges on how near miss morbidity has been defined and measured in the included studies, our results suggest that a substantial percentage of abortion-related hospital admissions have potentially life-threatening complications. Estimates that are more reliable will only be obtained with increased use of standard definitions such as the WHO near-miss criteria and/or better reporting of clinical criteria applied in studies

Photoactive nano-confined Pt in titania nanotubes (Pt-TiNT) via microwave-assisted flow synthesis

Pt-TiNT with PtO nanoparticles dispersed within the lumen and interlayer spaces of titania nanotubes (TiNT) were prepared by a new process involving titanate nanosheets (TiNS) synthesis in an optimized microwave-assisted flow reactor, followed by ion-exchange with a Pt precursor, before triggering the titanate layer rolling to trap the Pt precursor clusters inside the titania nanotubes, followed by a thermal treatment. TEM, XRD, and Raman analyses confirm the total conversion of TiO2 into TiNS in 15 min at 120 °C and 4 bar, and the TiNS transformation into 181 nm-long TiNT with 10 and 6 nm outer and inner diameter, respectively. The 2% Pt-TiNT comprises 0.7 nm PtO clusters (according to XPS), causing slight distortions of the interlayer spaces, while a few larger 2–3 nm Pt clusters reside within the lumen. As a result, Pt-TiNT is 14-fold more active than TiNT for visible light (400–780 nm) photocatalytic oxidation of diclofenac under 2136 μW·cm−2 irradiation, and>1000-fold better than the uncatalyzed photoconversion reaction under 100 mW·cm−2 artificial solar lighting. In addition, nano-confinement of PtO clusters narrowed the bandgap of the TiNT, which, combined with its excellent absorptivity to harvest light, allowed a broader spectral range of photon energies to activate the photocatalyst.11 página

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Study of the B−→Λc+Λˉc−K−B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-} decay

The decay $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ is studied in proton-proton collisions at a center-of-mass energy of $\sqrt{s}=13$ TeV using data corresponding to an integrated luminosity of 5 $\mathrm{fb}^{-1}$ collected by the LHCb experiment. In the $\Lambda_{c}^+ K^{-}$ system, the $\Xi_{c}(2930)^{0}$ state observed at the BaBar and Belle experiments is resolved into two narrower states, $\Xi_{c}(2923)^{0}$ and $\Xi_{c}(2939)^{0}$, whose masses and widths are measured to be $$m(\Xi_{c}(2923)^{0}) = 2924.5 \pm 0.4 \pm 1.1 \,\mathrm{MeV}, \\ m(\Xi_{c}(2939)^{0}) = 2938.5 \pm 0.9 \pm 2.3 \,\mathrm{MeV}, \\ \Gamma(\Xi_{c}(2923)^{0}) = \phantom{000}4.8 \pm 0.9 \pm 1.5 \,\mathrm{MeV},\\ \Gamma(\Xi_{c}(2939)^{0}) = \phantom{00}11.0 \pm 1.9 \pm 7.5 \,\mathrm{MeV},$$ where the first uncertainties are statistical and the second systematic. The results are consistent with a previous LHCb measurement using a prompt $\Lambda_{c}^{+} K^{-}$ sample. Evidence of a new $\Xi_{c}(2880)^{0}$ state is found with a local significance of $3.8\,\sigma$, whose mass and width are measured to be $2881.8 \pm 3.1 \pm 8.5\,\mathrm{MeV}$ and $12.4 \pm 5.3 \pm 5.8 \,\mathrm{MeV}$, respectively. In addition, evidence of a new decay mode $\Xi_{c}(2790)^{0} \to \Lambda_{c}^{+} K^{-}$ is found with a significance of $3.7\,\sigma$. The relative branching fraction of $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ with respect to the $B^{-} \to D^{+} D^{-} K^{-}$ decay is measured to be $2.36 \pm 0.11 \pm 0.22 \pm 0.25$, where the first uncertainty is statistical, the second systematic and the third originates from the branching fractions of charm hadron decays.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-028.html (LHCb public pages

Measurement of the ratios of branching fractions R(D∗)\mathcal{R}(D^{*}) and R(D0)\mathcal{R}(D^{0})

The ratios of branching fractions $\mathcal{R}(D^{*})\equiv\mathcal{B}(\bar{B}\to D^{*}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(\bar{B}\to D^{*}\mu^{-}\bar{\nu}_{\mu})$ and $\mathcal{R}(D^{0})\equiv\mathcal{B}(B^{-}\to D^{0}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(B^{-}\to D^{0}\mu^{-}\bar{\nu}_{\mu})$ are measured, assuming isospin symmetry, using a sample of proton-proton collision data corresponding to 3.0 fb${ }^{-1}$ of integrated luminosity recorded by the LHCb experiment during 2011 and 2012. The tau lepton is identified in the decay mode $\tau^{-}\to\mu^{-}\nu_{\tau}\bar{\nu}_{\mu}$. The measured values are $\mathcal{R}(D^{*})=0.281\pm0.018\pm0.024$ and $\mathcal{R}(D^{0})=0.441\pm0.060\pm0.066$, where the first uncertainty is statistical and the second is systematic. The correlation between these measurements is $\rho=-0.43$. Results are consistent with the current average of these quantities and are at a combined 1.9 standard deviations from the predictions based on lepton flavor universality in the Standard Model.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-039.html (LHCb public pages

A blood atlas of COVID-19 defines hallmarks of disease severity and specificity.

Treatment of severe COVID-19 is currently limited by clinical heterogeneity and incomplete description of specific immune biomarkers. We present here a comprehensive multi-omic blood atlas for patients with varying COVID-19 severity in an integrated comparison with influenza and sepsis patients versus healthy volunteers. We identify immune signatures and correlates of host response. Hallmarks of disease severity involved cells, their inflammatory mediators and networks, including progenitor cells and specific myeloid and lymphocyte subsets, features of the immune repertoire, acute phase response, metabolism, and coagulation. Persisting immune activation involving AP-1/p38MAPK was a specific feature of COVID-19. The plasma proteome enabled sub-phenotyping into patient clusters, predictive of severity and outcome. Systems-based integrative analyses including tensor and matrix decomposition of all modalities revealed feature groupings linked with severity and specificity compared to influenza and sepsis. Our approach and blood atlas will support future drug development, clinical trial design, and personalized medicine approaches for COVID-19

Pilotstudie av Fluorerade Ingredienser i Scotchgardprodukter och Deras Halter i Avloppsslam från Reningsverk och Lakvatten från Deponier i Sverige

This study performed by Örebro University on behalf of the Swedish Environmental Agency aims at assessing the occurrence and levels of the newly identified side-chain fluorinated polymers from an environmental perspective. The aims of present study are 1) to develop instrumental and extraction methods to measure the active ingredient of two Scotchgard products (two side-chain fluorinated polymers, hereafter referred to as Pre-2002 and Post-2002) in sludge and leachate samples from Swedish wastewater treatment plants and landfills; 2) to evaluate if Pre-2002 and Post-2002 may be responsible for the unidentified organofluorine in the sludge samples from our previous screening study reporting extractable organofluorine (EOF); and 3) to conduct a mass balance analysis on EOF and sum of 93 per- and polyfluoroalkyl substances (PFAS) including Pre-2002 and Post-2002 in the sludge and landfill leachate samples to assess the levels of unidentified EOF that potentially are other polymeric or non-polymeric PFAS. Levels of Pre-2002 and Post-2002 and EOF are reported for sludge samples from four wastewater treatment plants (Bergkvara in Torsås, Gässlösa in Borås, Henriksdal in Stockholm, and Öhn in Umeå) collected in 2015, and leachate samples from three different landfills (Atleverket in Örebro, Hässleholm Kretsloppscenter in Hässleholm, and Flishult in Vetlanda). Sludge samples from Gässlösa wastewater treatment plant collected between 2004 and 2016 (excluding 2005 and 2006) were analyzed to assess any temporal trends of the two side-chain fluorinated polymers (Pre-2002 and Post-2002). The present investigation reported levels of both Pre-2002 and Post-2002 in all sludge samples (158-2618 ng/g d.w.). Levels of Pre-2002 were always higher than those of Post-2002 in the same samples. A declining trend was observed for Pre-2002 in sludge samples from Gässlösa but no clear trend was noted for Post-2002. The concentrations of the Pre-2002 and Post-2002 in sludge were higher than the sum of 83 PFAS analyzed in the previous screening study. No relationship between number of people that the wastewater treatment plants served and the concentrations of EOF and Pre-2002 and Post-2002 could be observed. The concentrations of both EOF and Pre-2002 and Post-2002 seem to be more related to the types of industry located in that area. Only three of the five leachate samples showed detectable levels of Pre-2002. Post-2002 was not detected in any of the landfill leachates. The low levels could be due to that both compounds are strongly sorbed to particles, which indicates the fate and distribution of these compounds. For both the sludge and leachate samples, the quantified levels of Pre-2002 and Post-2002 only contributed to a minor part of the EOF. A high proportion of unknown EOF still remains and may be related to other polymeric or non-polar PFAS.Denna rapport innefattar en pilotstudie där två nyligen upptäckta polymerer med fluorerade sidokedjor studeras ur ett miljöperspektiv genom att undersöka deras förekomst och nivåer i svenska slam- och lakvattenprover. Syftet med denna studie var 1) att utveckla extraktions- och instrumentella metoder för analys av den aktiva ingrediensen i två Scotchgardprodukter (vilka benämns i denna rapport som Pre-2002 and Post-2002) i slam- och lakvatten från svenska reningsverk och deponier; 2) att utvärdera om Pre-2002 och Post-2002 kan förklara en del av halten oidentifierat organiskt fluor (OF) i slamprover som visats i vår tidigare screeningstudie; och 3) att genomföra en massbalansanalys av extraherbart OF (EOF) och Σ93PFAS inklusive Pre-2002 och Post-2002 i slam- och lakvattenprover för att bedöma delen av okänt EOF som potentiellt kan vara andra PFAS ämnen. I denna studie rapporteras koncentrationer av Pre-2002 och Post-2002, samt EOF för slamprover från fyra reningsverk (Bergkvara i Torås, Gässlösa i Borås, Henriksdal i Stockholm och Öhn i Umeå) insamlade under 2015, samt lakvattenprover från tre olika avfallsdeponier (Atleverket i Örebro, Hässleholm Kretsloppscenter i Hässleholm och Flishult i Vetlanda). En tidstrend av halterna Pre-2002 and Post-2002 mellan 2004 och 2016 (2005 och 2006 saknades) utfördes i slamprover från Gässlösa reningsverk. Detekterade koncentrationer av både Pre-2002 och Post-2002 hittades i alla slamprover (158-2618 ng/g d.w.). En minskning i koncentration av Pre-2002 kunde ses från 2004 till 2016 i slamprover från Gässlösa reningsverk, medan ingen trend för Post-2002 observerades. Halten av Pre-2002 and Post-2002 var högre än summan av de 83 PFAS-ämnen som analyserats i den tidigare screeningstudien. Inget tydligt samband kunde ses mellan antalet personer anslutna till reningsverket och halterna av oidentifierat EOF samt de detekterade polymererna med fluorerade sidokedjor. Nivåerna av EOF, Pre-2002, och Post-2002 visade sig vara relaterat främst till typ av industriell verksamhet i anslutning till reningsverket. Endast tre av fem lakvattenprover visade detekterbara koncentrationer av Pre-2002. Post-2002 detekterades inte alls i lakvatten. De låga nivåerna i lakvattenproverna kan förklaras av att Pre-2002 och Post-2002 starkt adsorberar till partiklar, vilket visats i andra studier. Detta ger ytterligare en inblick i hur dessa ämnen transporteras i miljön. Andelen av Pre-2002 och Post-2002 i både slam och lakvattenproverna är låg i förhållande till halten EOF, som fortfarande utgörs av en stor andel oidentifierat EOF. Den stora mängden okänt EOF kan därför ha sitt ursprung i andra icke- eller polymeriska PFAS-ämnen

Screening of per- and polyfluoroalkyl substances (PFAS) in sediment and water close to paper industries

Per- and polyfluoroalkyl substances (PFAS) is a large group of anthropogenic compounds that is widely used, for example to manufacture grease- and water-repellent paper. Several PFAS have been found to pose a risk to the environment and humans due to their persistency, mobility, toxicity and bioaccumulative potential. Paper production in Sweden covers widely different products such as cardboard, liquid cardboard, writing paper, sack paper, hygiene paper (tissue), etc. In addition, there are also numerous closed paper industries. Current and historical use of PFAS in paper industries in Sweden and consequent emissions to the environment are not known. The purpose of this study was to assess if paper industries could be an important point source for PFAS in the environment by analysis of PFAS in sediment and water taken nearby paper industries. In total, 60 sediment samples from 13 sites in Sweden sampled during the time period 2015-2022, and eight surface water samples from three sites taken in 2021, were included in the study. A total of 68 non-polymer PFAS and extractable organofluorine (EOF) was targeted. The results from the screening study shows a wide range of the sum target PFAS-68, between below limit of detection (LOD) to 1181 ng/g dry weight (d.w.) in sediments close to paper industries in Sweden. The number and type of PFAS detected also varied. The PFAS-classes found in highest concentration in surface sediments were polyfluoroalkyl phosphate diesters (diPAP) (maximum 819 ng/g d.w.), fluorooctanesulfonamidoacetic acid (FOSAA) (maximum 137 ng/g d.w.), and N-ethyl perfluorooctane sulfonamido ethyl phosphate diester (diSAmPAP) (maximum 134 ng/g d.w.). DiSAmPAP was only semi-quantified due to poor separation of structural isomers and interferences from the sediment matrix. A general increase in concentrations with increasing sediment depth could be seen for the contaminated sites, and the maximum concentration in sediments of different depths reached 1084 ng/g d.w. for diPAP, 65 ng/g d.w. for FOSAA, and 682 ng/g d.w. for diSAmPAP. The commonly measured classes of perfluoroalkyl acids (PFCA) and perfluoroalkyl sulfonic acids (PFSA) reached a maximum of 6 and 7 ng/g d.w. in surface sediments, and 11 and 6 ng/g d.w. in sediment cores, respectively. The EOF levels followed the same trend as target PFAS concentrations, with a few exceptions, and ranged between <LOD to 1301 ng/g d.w.. Surface water from three sites showed detectable concentrations of PFCA, PFSA och FTSA up to 0.05 ng/mL, but the occurrence could not be connected to the paper industries. Based on the target results of surface sediments, five out of the 13 sites can be classified as low contaminated (sum target PFAS-68 <20 ng/g d.w.) and the remaining eight sites are clearly affected by a PFAS point source.Per- och polyfluoralkylsubstanser (PFAS) är en stor grupp antropogena föreningar med bred användning, till exempel vid tillverkning av fett- och vattenavvisande papper. Flera PFAS har visat sig utgöra en risk för miljön och människor på grund av deras persistens, rörlighet, toxicitet och bioackumulerande egenskaper. Pappersproduktionen i Sverige omfattar olika typer av produkter såsom kartong, flytande kartong, skrivpapper, säckpapper, hygienpapper, etcetera. Nuvarande och historisk användning av PFAS i svensk pappersindustri kopplat till utsläpp till miljön är inte känd. Syftet med denna studie var att bedöma om pappersindustrier kan vara en viktig punktkälla för PFAS i miljön genom analys av PFAS i sediment och vatten i närheten av pappersindustrier. Totalt ingick 60 sedimentprover från 13 platser i Sverige provtagna under tidsperioden 2015–2022, och åtta ytvattenprover från tre platser tagna 2021. Analysen omfattade totalt 68 PFAS (icke-polymerer) och extraherbart organiskt fluor (EOF). Resultaten visar ett stort koncentrationsområde i sediment nära pappersindustrier i Sverige, från under detektionsgränsen (LOD) till 1181 ng/g torrvikt. Antalet och typen av detekterade PFAS varierade också. De PFAS-klasser som hittades i högst koncentration i ytsediment var polyfluoralkylfosfatdiestrar (diPAP, max 819 ng/g), fluoroktansulfonamidättiksyra (FOSAA, max 137 ng/g) och ämnet N-etylperfluoroktansulfonamidfosfatdiester (diSAmPAP, max 134 ng/g d). Koncentrationerna för diSAmPAP är semi-kvantifierade då matris och isomerer störde kvantifieringen. En generell ökning av koncentrationerna med ökande sedimentdjup kunde ses och den maximala koncentrationen i sediment från olika djup nådde 1084 ng/g för diPAP, 65 ng/g för FOSAA och 682 ng/g för diSAmPAP. De klasserna som vanligtvis mäts i undersökningar, PFCA och PFSA, nådde maximalt 6 och 7 ng/g i ytsediment, och 11 och 6 ng/g i sedimentkärnor. EOF följde samma trend som PFAS-koncentrationerna, med några få undantag, och varierade mellan <LOD till 1301 ng/g. Ytvatten från tre platser visade detekterbara koncentrationer av PFCA, PFSA och FTSA upp till 0,05 ng/ml, men kunde inte kopplas tillNATIONELL MILJÖÖVERVAKNING PÅ UPPDRAG AV NATURVÅRDSVERKETÄRENDENNUMMERAVTALSNUMMERPROGRAMOMRÅDEDELPROGRAMNV-06307-20219-20-008MiljögiftsamordningScreening3pappersindustrierna i denna studie. Baserat på PFAS-analysen av sediment är åtta av de 13 platserna tydligt påverkade av punktkälla och fem kan klassificeras som lågkontaminerade (summa PFAS-68 <20 ng/g) även om påverkan från närliggande industrier inte helt kan uteslutas